title: Mid-term results of endovascular coiling of wide-necked aneurysms using double stents in a Y configuration.
abstract: BACKGROUND
  Double stenting in a Y configuration may be used to treat a subset of wide-necked aneurysms not amenable to reconstruction with a single stent.
  
  
  OBJECTIVE
  We studied the feasibility, safety, and mid-term angiographic outcome of patients treated using this technique.
  
  
  METHODS
  A retrospective review was undertaken of all coil embolizations of wide-necked aneurysms using double stents in a Y configuration.
  
  
  RESULTS
  Nineteen patients were identified from 2002 to 2010 (14 women, 5 men) with a mean age of 57.4 years. Stents were deployed in a Y configuration achieving complete occlusion (5/19), residual neck (5/19), and residual aneurysm filling (9/19). Angiographic follow-up was available for a mean of 16 months, and clinical follow up was available for a mean of 21.4 months. The incidence of complications at the initial treatment was 6 of 19 (31.6%), and delayed thromboembolic complications occurred in 2 of 19 (10.5%). An angiographic neck recurrence requiring retreatment developed in only 1 of the patients in whom complete occlusion was obtained with the initial treatment. Spontaneous thrombosis and complete occlusion on follow-up imaging were found in 6 patients in whom initial neck or aneurysm filling was observed. Ultimately, 12 of the aneurysms (63.2%) were completely occluded on follow-up angiography.
  
  
  CONCLUSIONS
  Y-stent reconstruction enables the endovascular management of otherwise complex, wide-necked cerebral aneurysms and can be performed safely in experienced hands with satisfactory mid-term results, even in cases requiring retreatment.
authors.affiliation: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Alejandro M
authors.initials: AM
authors.lastname: Spiotta
authors.forename: Rishi
authors.initials: R
authors.lastname: Gupta
authors.forename: David
authors.initials: D
authors.lastname: Fiorella
authors.forename: Vivekananda
authors.initials: V
authors.lastname: Gonugunta
authors.forename: Bjorn
authors.initials: B
authors.lastname: Lobo
authors.forename: Peter A
authors.initials: PA
authors.lastname: Rasmussen
authors.forename: Shaye I
authors.initials: SI
authors.lastname: Moskowitz
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015607:Stents